Doctor Name: | DR. NANCY J CONNOLLY |
NPI Number: | 1154459097 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSY.D. |
License Number: | 6772 |
Business Practice Address: | 35 Braintree Hill Park Suite 100 Braintree, MA - 021848703 |
Business Phone Number: | 7818438887 |
Business Fax Number: | 7818433179 |
Mailing Address: | 35 Braintree Hill Park, Suite 100 BRAINTREE |
State: | MA |
Postal Code: | 021848703 |
Phone Number: | 7818438887 |
Fax Number: | 7818433179 |
NPI Enumeration Date: | 03/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TF0200X |
License Number: | 6772 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Forensic |
Taxonomy Definition: |